Abstract
The aim of this study was to determine the resistance patterns and ESBLs production among clinical isolates of Escherichia coli and Klebsiella pneumoniae in two government hospitals of Delta State, Nigeria. Urine, blood and wound samples were aseptically collected from hospitalized patients, bacteriologically processed and isolates identified using standard protocols. Antimicrobial susceptibility testing was determined by disc diffusion method. The plasmid DNA of Multidrug resistance (MDR) isolates were extracted by alkaline lysis method. Phenotypic ESBL production of the MDR isolates was done by Double Disc Synergy Test (DDST) while PCR was used to detect blaCTX-M, blaSHV and blaTEM among isolates. A total of 217 isolates were obtained, of which 161(74.2%) and 56(25.8%) were Escherichia coli and Klebsiella pneumoniae respectively. The antimicrobial resistance varied from one location to another. All isolates obtained from blood of general hospital Warri (GHW) were 100% resistant to amoxicillin clavulanic acid and the cephalosporins (ceftazidime, cefotaxime, and cefuroxime). Isolates from General hospital Agbor (GHA) showed high resistance of 75.0% to cefotaxime, 93.8% to each of ceftazidime and cefuroxime. Overall low resistance to nitrofurantoin was observed in E. coli isolates obtained from urine of GHW (27.5%) and GHA (20.8%). Out of 217 isolates, 75.1% (163/217) were MDR, of which 36.8% and 39.3% produced ESBL by DDST and PCR respectively. The most common ESBL gene was blaCTX-M expressed by 28(17.2%) of the isolates. The high prevalence of MDR and ESBL underscores the need for a continuous local monitoring of antibiotic resistance.
 
Highlights
Antimicrobial resistance (AMR) is increasing at an alarming rate despite the campaigns against AMR by numerous international and national health summits and conferences
A total of 217 non-duplicate clinical isolates of E. coli and K. pnuemoniae from urine 108 (49.8%), wound 61 (28.1%) and blood 48(22.1%) of government owned hospitals located in Warri (GHW- General Hospital Warri) and Agbor (GHA General Hospital Agbor) were obtained in this study (Figure 1)
Isolates from general hospital Warri (GHW) exhibited higher levels of resistance to most of the antibiotics than isolates obtained from General hospital Agbor (GHA)
Summary
Antimicrobial resistance (AMR) is increasing at an alarming rate despite the campaigns against AMR by numerous international and national health summits and conferences. Almost all antibiotics are available over the counter in most developing Sub-Saharan African countries and can be bought without prescription (Zaman et al, 2010; Essack et al, 2017). The intense use of antibiotics in hospitalized patients is an important factor promoting the emergence of multidrug resistance (MDR) in Sub Saharan-African countries, thereby leading to difficulties finding appropriate treatment and increased mortality and morbidity (Aly et al, 2008; Essack et al, 2017). A major issue in the increasing incidence of resistance in these antibiotics is the production of enzymes such as Extended Spectrum Beta-Lactamases (ESBLs). Hospitalization has been identified as a major risk factor to express ESBL (Stadler et al, 2018) resulting in a corresponding multiple drug resistance and FUDMA Journal of Sciences (FJS) Vol 5 No., June, 2021, pp 584 - 595
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